INTRODUCTION In the United States, injections of botulinum neurotoxin (BoNT) to diminish horizontal forehead wrinkle lines, glabellar (central brow) frown lines and lateral canthal rhytides (crow’s feet) are the only cosmetic and aesthetic indications approved by the Food and Drug Administration (FDA) in the United States of America (USA).1-3 Injecting BoNT for cosmetic purposes in any other part of the face or body is not approved in the United States (US) by the FDA and therefore is considered o label use.1-3 It remains to be seen whether the FDA and other governmental regulatory agencies of other countries will ever approve every single indication for which the BoNTs have proven to be eective in clinical practice. e fact remains that BoNTs are extremely reliable, nontoxic, and safe.1-6 BoNTs provide reproducible results when administered as prescribed. Consequently, BoNTs have now become a major component of the armamentarium of any physician who practices aesthetic medicine in any capacity and who wants to produce the best cosmetic results for their patients.